Introduction
Improvements in the medical field have resulted in the development of several treatment approaches aimed at enhancing long term recovery. In view of this, alternative approaches such as art and music therapy have become popular with much of their application observed in mental and emotional health. Therapeutic
Treatment as a form of alternative approach in addressing the needs of disability and mental problems has revolutionized healthcare industry Ausebel (2002: 32-38). The increase in the number of mental health cases and disability problems has occasioned the invention of other treatment approaches that will result in better prognosis for patients. This essay will develop a research study aimed at coming up with a holistic approach in the treatment of mental health illnesses. Over the last few years, music, dance and art have proved effective and cost effective in the management of mental and disability problems. Not only do they reduce stress and allow efficiency in blood circulation, but also encourage dependency and alertness among the mentally ill. Owing to limitation in literature regarding the alternative therapies, the study will employ group psychotherapy while presenting the process of collecting data from the sample
Problem identification
Mental health conditions have become common illnesses due to a constellation of predisposing factors across all age groups. While biological factors and genetic make up is overly responsible for a sizeable proportion of cases, literature has shown an increasing trend of illnesses brought about by the social environment. Drug abuse, strained family relationships and hard economic times are blamed for the high number of mental illnesses particularly among the youths and adolescents. Taking into account that adolescent period is an important period in life; psychological harm may manifest itself later in life. The accelerated and rapid physical and mental growth has made adolescent a very important priming stage in life. Studies have indicated a gap in the application of therapeutic approach among the adolescents with challenges in relation to psychological health. Ausebel (2002: 32-38) points out that scholars, educators, politicians and health workers have never adequately covered therapeutic study. The study indicated that a high number of girls reported higher degree of interpersonal sensitivity than boys in areas such as depression, anxiety among other therapeutic conditions (Stein, 2006: 27). Cultural factors have in essence contributed to increased cases of psychological symptoms among the adolescent. For instance, the pressure to succeed in education, great expectations from parents and peer pressure result in high tendencies of developing mental conditions which may range from mild to life threatening. In tandem with the above, the study will suggest the application of music therapy in addressing the upsurge in mental illness among the youths and adolescents.
Aim and research questions
The aim of this research is to test the applicability of music therapy in management of disability and mental health conditions. The study is informed by the increase in the number of cases of disabilities and mental health illnesses that subsequently leads to dependency. In devising this proposal, it is anticipated that music therapy will enhance the treatment process while allowing the sufferers to be independent.
To ensure the study objectives are achieved, several questions were developed. The research questions included:
- What benefits are conferred through utilization of music therapy in the treatment process?
- Which are the factors that influence the efficacy of the therapeutic process and what are the possible ways of improving them?
- What improvements are observed in the treatment outcomes in the patient?
Definitions of key terms and concepts
Although music therapy has become useful to psychiatry, there is minimal information regarding its efficiency in instilling positive changes in the lives of the patients. In essence, majority of the researchers’ have decried the difficulties they faced while undertaking the studies (Aldridge 1993: 32; Silverman 2005: 54). While various studies have explained the various approaches and aspects of the therapeutic approaches, there is need to define key terms and concepts useful in the alternative methods of treatment.
Malchiodi (2003: 1) defines therapeutic approach as the usage of art, music and any other form of creative art in informing psychotherapy while influencing the course of counseling and rehabilitative care. Music therapy falls under a wider group of expressive therapies that have proved important in psychiatry and psychotherapy. In order to differentiate the other approaches from music therapy, it is imperative to define their scope and application in today medical field. To start with, art therapy as an approach utilizes art media coupled with images to create a process that takes into account the client response to the applied technologies as a representation of development, conflicts and personalities coupled with emotional concerns. According to the American Art Therapy Association (2004: 54), this offers a better approach under which reconciliation of emotional conflicts and development of social skills occurs. In addition, art therapy reduces anxiety while helping the patient to have self awareness that is useful in aiding reality orientation hence boosting the self-esteem (Chlan 2009: 47).
On the other hand, the American music therapy association has denoted music therapy as the application of music in influencing the occurrence of positive changes particularly in the physical and social functioning of clients who are overly suffering from health problems (American Music Therapy Association 2004: para.3). in contrast with music therapy, play therapy refers to the systematic application of conceptual frameworks aimed at establishing processes at the interpersonal levels thereby allowing play therapists to develop and integrate their powers in helping resolve the psychosocial difficulties. Landreth (1991: 12) further noted that achievement of outcomes and optimal growth is enhanced through the systematic incorporation of the theoretical models into the treatment process. In addition to the above approaches, Knill, Barba and Fuchs (1995: 34) denoted that an integrated art approach is gaining prominence in various setting. In essence, they defined the approach as an intersection of two or more forms of therapies aimed at fostering awareness while encouraging the growth of emotions and relationships.
Although all the therapeutic approaches serve to bring positive outcomes, inherent differences exist among them. This means that each form of therapy has its own unique properties that enhance its roles in management of mental condition. The efficiency is overly influenced depending on its application and the setting with regard to the client and practitioner.
Literature review
Adolescent mental health conditions have gained popularity and raised a lot of concern among the health specialists and policy makers. The wide scope of the causative factors and dynamics in this category makes the study of adolescent mental health a difficult task. The fact that the group is undergoing, massive changes means that failure to address the root causes of the psychological problems may result in terrible outcomes in terms of social interaction in future life. Riley (1999:67) pinpoints that peer relationships has formed the core of adolescent group with direct impact on their behaviors. This is occasioned by the fact that a boy or a girl tries to establish and mark his or her identity in the dynamic social setting. The support required in accomplishing this noble task mainly entails development of social competency, intimacy and personal well being. In addition, Steiner (2006: 67) observes that the girls are overly associated with depression and ideas of suicide because of its linkage with interpersonal relatedness. Female gender is prone to interpersonal stress
In the last few decades, music therapy studies have proved pivotal in improving the diagnostic and treatment process in mental health. In fact, the studies have provided the clinicians and medical researchers with invaluable information that has greatly informed the trends in clinical practice. While the method of data collection has varied greatly, their findings have contributed immensely in defining the trends in the public and largely in private practice. More importantly, the development and utilization of data collection tools such as postal mail, web based or the more recent online interviews have brought forward minimal differences in terms of findings. In view of the benefits conferred by the above, paper surveys are becoming less efficient owing to various changes in technology (Silverman 2007: 388). Silverman (2007: 403) further denoted the embracement of web based surveys owing to the accessibility and convenience afforded, taking into account the high level of connectivity and familiarity with computers and related technology. Although these findings were in contradiction with previous studies (Fraze et al 2003: 143; Matz 1999: 98), it should be noted that previous studies were conducted when computer literacy was at its infancy, and thus representing a paradigm shift from the traditional approaches.
Female gender is prone to inter personal stress and symptoms of depression during the adolescence period, because of the affiliation and social personality or due sensitivity of some of the life stressful patterns, Ausubel (2002:67). Girls are susceptible to pressure intimacy than their male counterparts. Furthermore, they are more susceptible to actions, which are prone to stress unlike the boys. Girls’ identity during adolescent is linked to interpersonal relationship in comparison to boys Parrott (2000:67). Music has been one of the most important therapeutic and efficient methodologies in the management and treatment among the adults. Therapeutic music can be administered in a variety of ways, but the most preferred is the “group psychotherapy” Kroger (2004:65). Music can be effectively used in patients who have chronic mental disorder, in this scenario; music therapy provides a relaxing mood and encourages group cohesion and bonding. In some situation such as stress, music therapy has contributed significantly in lowering stress and improving moods in adults (Carroll 2008: 103).
Adolescents’ relationships among peers are important in setting the foundation for the development of social competence and avenues for intimacy. In addition, the adolescents are equipped with vital skills in developing their well being and fulfillment of needs particularly at the social level (Fraze et al 2003: 147). Cross sectional studies espouses processes in interpersonal relatedness serve as influencers while protecting the adolescents from falling into maladjustments, characteristics of the youth group. Furthermore, social isolation observed in girls has been linked with depression and higher tendencies of suicidal ideation. More importantly, the likelihood of girls reporting strenuous experiences is usually higher compared to boys owing to their nature. Furthermore, girls have higher chances of reporting peer related occurrences that meet the criterion of being harmful and stressful (Parrott 2000: 74).
Music is one form of art that confers immense therapeutic and overly protective effects not only in adults but also in adolescents’ especially in health settings. In essence, several methodologies have received utilization in measuring the level of anxiety and stress among patients and clients accessing healthcare services (McKinney et al1997: 87). Mok and Wong (2003: 12), in an investigation of forty patients, denoted that those who were able to listen to their favorite music while undergoing surgery reported better and positive outcomes with regard to anxiety levels(Chlan 2009: 49). Further studies asserted that decreased heart rates and improved respiratory rates in patients overly dependent on mechanical ventilators. Synchronization of the heart rates with the rhythmic beats of the music overly brought a stabilization and decrease to the normal rates of the heart and respiratory parameters (Chlan 2004: 45). In addition, its application in group therapy has been espoused in other studies whereby it helped develop group cohesion particularly in patients with chronic mental illnesses (Thaut 1999: 76).
Stress levels are overly reduced when music therapy is overly integrated in the treatment process. In addition, an improvement in mood occurs in adults and largely on adolescent girls. In a case control study involving 17 healthy individuals with a control group of 19 participants, a marginal decrease in depression mood was observed in the former after exposure to several weeks of music. The incorporation of music in solving self-established concerns brought about improvements in the healthy participant. Music in combination with personal concerns inherently led to the development of therapeutic effects (McKinney et al1997: 87). Clair (1996: 57) asserts that music therapy promotes both verbal and non verbal forms of communication hence leading to improved social interaction. In essence, it assists patients to express themselves without necessarily indulging in idle talk (Hogan 1997: 12). In addition, it plays an important role in managing pains through shifting attention from the treatment procedure. On the other hand, dancing slows down progression of mental disorders by allowing patients to develop cognitive symptoms that have neuro protective effects Clair (1996: 69).
Incorporation of new methodologies in the treatment of patients suffering from mental health conditions rather than relying on the traditional medications has greatly influenced their management (Chodorow 1991). In essence, the integration of art, music and dance brings a sense of relief, through the entertainment element, which helps bring down the pain levels. While the efficacy of the various methods may not be ascertained, it remains clear that increased usage of music therapy confers the patient with better prognosis (Hogan 1997: 18). This study will try to ascertain the efficacy of music therapy as an interventional strategy in management of mental health conditions in adolescents Clair (1996: 69).
Methodological approach
Subjects
Participants in the pilot study will come from a mixed school in one of the largest city in United Kingdom. A total of 40 9th graders in one class were overly selected for the study. The age ranged from 14-15 years with a conservative mean age of 15 years. 23 participants were females while the rest were males. The students were duly informed the motive of the study was to examine the effectiveness of music therapy in the treatment of mental health disorders among adolescents. The principal investigator also informed that the study consisted of 5music group psychotherapy sessions. In accordance with ethics, the school administration gave the green light for the study while informed consent was sought from the participants. In addition, a confidential letter describing the purpose of the study was sent to each of the 40 students parents. In addition, the participants and their parents were assured of their privacy with high level of confidentiality was to be exercised with regard to the particulars of the participants. More importantly, the participants were informed that they were free to withdraw from the study at their own time if they felt the study was bringing negative consequences to their lives. After taking them through the rigorous process, all the participants duly agreed to continue with the study.
Procedures
The music group psychotherapy was the preferred method of undertaking the study. The method consisted of five sessions whereby each took 90 minutes to complete. The study period will be conducted between September and October 2010. Participants will attend four sessions every fifth day of consecutive week with the last session taking place 5weeks later. In addition, each session will be conducted in a group discussion before the participants are split into 8 groups of 5 participants, with random selection of the participants being the basis of division.
A strict protocol was followed when coming up with therapeutic music intervention to be applied in the group psychotherapy. The overall goal of the intervention was to promote the embracement of music therapy in the management of psychological disorders such as anxiety and stress. Five sessions were developed to address the various topics as espoused in the research objectives; benefits of music therapy, importance of friends, factors that influence efficiency of music therapy, identification of difficulties and shortcomings in relationships, effectiveness of music therapy and integration of self control, emotion and self behavior. The music activities incorporated in the sessions will be under the guidance of a certified music therapist with assistance from a psychiatric nurse.
Next, the 40 participants will be brought into terms with the objectives and the overall psychotherapy process. A music experience, from the united kingdom, with relevance to the issues on hand will be presented by the music therapist. Incorporation of the topical issues together with singing, listening and body movements will occur to enhance the understanding of the concepts. After each exposure, the small groups will reflect and discuss their experiences and the influence this had on their emotional and social life. The therapist will guide the participants in transferring their experiences by putting them in the context of their lives. In addition, the therapist will help the small groups to develop plans for therapeutic change through application of a problem focused approach. A review will then be conducted with all the participants to deduce the feedback from each of the 40 participants.
Data collection and analysis
Data collection and analysis will be achieved through group process observations and accounts of the participants.
Group process observations
In a bid to get a clear understanding of the process outcomes in the newly founded group, a variety of methods will be employed particularly in the analysis of the data collected. To start with, a video camera will be used to record each session before process evaluation occurs. After completion of each session, the primary investigator and the other therapists will conduct an evaluation of the whole intervention through analyzing the recorded video. Discussion and eventual summarization of the combined recordings will then occur.
Perceived change
The results of perceived changes that will be recorded during the follow up stage will be analyzed by using the participants own words. In essence, the responses will be grouped into 11 content areas thereby helping in bringing out a clear analysis of the anticipated change.
Limitations
The study lacks a control group in addition to the inadequacies brought about by lack of non specific effects coupled by failure to utilize measurement tools with standardized outcomes.
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